Global burden of tuberculosis among adults aged 60 years and older,1990-2021: findings from the global burden of disease study 2021

Tuberculosis (TB) poses a significant threat to global public health, particularly among the elderly. This study aim to provide a comprehensive analysis of the pattern and temporal trends of the global disease burden associated with HIV-negative TB in adults aged 60 years and older from 1990 to 2021. Data on incidence, deaths, and disability-adjusted-life-years (DALYs) of TB, drug-susceptible tuberculosis (DS-TB), multidrug-resistant tuberculosis (MDR-TB), and extensively drug-resistant tuberculosis (XDR-TB) were obtained from the Global Burden of Disease (GBD) 2021. Frontier analysis was carried out to pinpoint areas for enhancement and disparities among nations stratified by development level. Bayesian age-period-cohort model (BAPC) was utilized to forecast disease burden trends through 2035. A decline trend in age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and DALY rates for TB and DS-TB was observed among the elderly population globally, whereas an upward trend was noted of MDR-TB and XDR-TB. Frontier analyses revealed a potential for burden alleviation among diverse nations and regions, with high SDI nations like the Republic of Korea showing higher disease burden than expected for their sociodemographic development. BAPC model revealed that by 2035, the MDR-TB and XDR-TB burden will continue escalating in the elderly. The increasing MDR-TB and XDR-TB burden in older individuals underscores the need for tailored interventions to combat TB burden, such as implementing active case finding (ACF) among adults aged 60 years and older.